Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.
Issue link: http://outpatientsurgery.uberflip.com/i/685863
J U N E 2 0 1 6 O R E X C E L L E N C E . C O M 7 3 • Bundled approaches. We established bundles of care at Yale-New Haven Hospital for SSI prevention that include antibiotic prophylaxis, nasal decoloniza- tion and standardized skin preps. The Joint Commission and CDC want to see the bundles facilities have in place to standardize care, which gets all the stake- holders together to discuss the best ways to prevent specific kinds of infections. That way, they do the exact same thing for every single patient. Bundles estab- lish the standard of care and eliminate the variables that might lead to infection. • Endoscope reprocessing. We'll address the gap between national guidelines and actual practice. For example, if you store unused scopes in state-of-the-art cabinets with the right air exchanges and nobody touches them, you don't need to reprocess them every 5 days between uses, as AORN recommends. There's also variation in preparing scopes for reprocessing at the point of care — the time between when a scope exits the patient and when it gets placed into an automatic reprocessor. • Medication management. Anesthesia providers don't get proper education on how medication should be prepared for administration. They simply don't have a good working knowledge of safe injection practices and tend to cut corners. Anesthesia providers at many centers I've worked at ignore the "60-minute rule" — the length of time agents can remain in a syringe without being used — by drawing up medications for the entire day, instead of preparing medications for a specific case. Whenever I present on this topic, half of the audience hasn't even heard of the 60-minute rule, let alone understand the best ways to ensure it's fol- lowed. OSM